Towards marketization and centralization? The changing role of local government in long-term care in England, France, Germany and Italy

In a book that provides a comprehensive analysis of the provision of public services in some European countries, this chapter reconstructs key developments in long-term care in England, France, Germany and Italy since the beginning of the 1990s, with a view to identifying changes in the horizontal and vertical governance of services, that is, the role of public, commercial and non-profit organizations in service provision and the distribution of competencies among the different tiers of government. In line with the overall focus of the volume, special attention is paid to the changing role of local government regarding Long-term care, that is particularly suited for such a focus. Whereas in other fields of social policy such as pensions, health care or labour market policy, central government stepped in at an early stage, the responsibility for providing and financing services for the frail elderly was largely left with local governments in most OECD countries, until recently major reforms and changes have taken place.